A multifactorial intervention for the prevention of falls in psychogeriatric nursing home patients, a randomised controlled trial (RCT).

Abstract:

OBJECTIVE:to evaluate the effectiveness of a multifactorial intervention on incidence of falls in psychogeriatric nursing home patients. DESIGN:cluster-randomised controlled 12-month trial. SETTING:psychogeriatric wards in 12 nursing homes in The Netherlands. PARTICIPANTS:psychogeriatric nursing home patients (n = 518). INTERVENTION:a general medical assessment and an additional specific fall risk evaluation tool, applied by a multidisciplinary fall prevention team, resulting in general and individual fall prevention activities. MEASUREMENTS:falls. RESULTS:there were 355 falls in 169.5 patient-years (2.09 falls per patient per year) in the intervention group and 422 falls in 166.3 patient-years (2.54 falls per patient per year) in the control group. Intention-to-treat analysis with adjustment for ward-related and patient-related parameters, and intra-cluster correlation, showed that the intervention group had a significantly lower mean fall incidence rate than the control group (rate ratio = 0.64, 95% CI = 0.43-0.96, P = 0.029). Subgroup analyses showed that fall risk declined further as patients participated longer in the intervention programme. CONCLUSION:the introduction of a structured multifactorial intervention to prevent falls in psychogeriatric nursing home patients significantly reduces the number of falls. This reduction is substantial and of high clinical relevance.

journal_name

Age Ageing

journal_title

Age and ageing

authors

Neyens JC,Dijcks BP,Twisk J,Schols JM,van Haastregt JC,van den Heuvel WJ,de Witte LP

doi

10.1093/ageing/afn297

subject

Has Abstract

pub_date

2009-03-01 00:00:00

pages

194-9

issue

2

eissn

0002-0729

issn

1468-2834

pii

afn297

journal_volume

38

pub_type

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